Aid workers around the world often find themselves at risk, despite their efforts to remain above the conflict. Last year some 260 humanitarian workers suffered attacks -- 122 died. Taliban militants killed nine people, including at least six U.N. workers, in an attack on an international guesthouse in Kabul October 28.

Heavily armed militants stormed this Kabul guest-house used by several international organizations, including the United Nations. And the Taliban warned of more bloodshed in the lead up to the second round of voting in the Afghan elections.UN High Commission for Refugees spokesman Peter Kessler says there is great concern about the increasing number of attacks on aid workers. "They often realize that there's the U.N., there's the aid community, they are symbols of what 'I feel is wrong with this situation," he states, "They are symbols of western involvement. I'll target them.'"

UNHCR has lost three aid workers in Pakistan this year -- including a Serbian national who died in the bombing of a luxury hotel in Peshawar in June.

The attack on the guest house in Kabul contributes to a grim year in the region for the UN. Five aid workers died in Pakistan in early October in a bombing of the World Food Program's offices in Islamabad.

World Food Program senior spokeswoman Caroline Hurford states, "We've lost staff in Somalia, we've now lost staff in Pakistan, we've had injuries elsewhere, so we're very much aware of this dilemma, because our mandate is to try to get out to some of the most remote and dangerous regions where people really need our help," she said.

Some charities are replacing international aid workers with local nationals in an effort to reduce attacks. Heather Hughes is a security adviser with the charity group, Oxfam. "Our ability to be out in the countryside and be outside of Kabul has significantly decreased. We are much less able to travel freely than we were even two years ago," Hughes said.

UNHCR officials say their mandate is unchanged, but how the agency operates in conflict zones is evolving.

"Clearly we have to ensure that while we don't scale back the aid effort, in situations that are tenuous only the most vitally needed staff -- the staff doing the most important work -- are exposed to threats," Kessler asserts.

Aid officials say they their agencies are impartial, operating independently of any military force. But some agencies do work in partnership with armed forces -- the Netherlands and NATO provided naval escorts to secure the World Food Program's route into Somalia late last year.

Caroline Hurford says it was a matter of life or death for millions of Somalis, "Of course it's not necessarily a good thing to be accompanied by the military but if it's a question or getting food there or not, and helping out the hungry -- or not -- then I think it's worthwhile," she adds.

Once on dry land, the risk to humanitarians is great. Reaching the displaced and the desperate in Somalia means travelling through hostile, unstable regions.

But even when an aid agency operates in a low visibility capacity, Oxfam's Heather Hughes says the nature of humanitarian work means safety can never be guaranteed.

"We like to be able to identify what the risks are," Hughes says, "and then manage them to an extent that that's possible, but in any location where we work, we can't exclude risk altogether."

Whether it's in Afghanistan, Somalia or Sudan where terrorists often target aid workers, or more recently in Pakistan.